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Robotic arm-assisted unicompartmental knee arthroplasty: high survivorship and good patient-related outcomes at a minimum five years of follow-up

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Robotic arm-assisted unicompartmental knee arthroplasty (RA-UKA) has been shown to improve component placement, reduce intraoperative variability, increase patient satisfaction and improve short-term survivorship results. The aim of this retrospective study was to determine the incidence of revision and the clinical performance at a minimum of 5-year follow-up for a cohort of patients who received a medial RA-UKA.

Methods

Between April 2011 and July 2013, a total of 254 patients underwent medial RA-UKA at a single centre. Clinical performance was investigated using the Forgotten Joint Score-12 (FJS-12) and a 5-level Likert scale made of five items to assess joint perception and patient satisfaction. Kaplan–Meier implant survivorship was calculated and reasons for revision were collected. The effect of age, gender and body mass index (BMI) on the probability of reporting high FJS-12 and satisfaction were assessed.

Results

After considering exclusion criteria and loss to follow-up, a total of 216 patients (224 medial RA-UKAs) were assessed at a mean 5.9 years of follow-up. Five RA-UKAs underwent implant revision, resulting in an overall Kaplan–Meier survivorship of 97.8%. Unexplained knee pain (0.9%) was the most common reason for RA-UKA revision. Good-to-excellent FJS-12 scores and high satisfaction levels were reported at mid-term follow-up. Male patients had higher probability of having FJS-12 > 90 (p < 0.05) and high satisfaction levels (p < 0.05).

Conclusions

RA-UKAs demonstrated high survivorship and good-to-excellent patient-reported outcome measures and satisfaction levels at minimum 5-year follow-up. Results for male patients had improved clinical performance when compared to female subjects.

Level of evidence

IV.

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Abbreviations

ACL:

Anterior cruciate ligament

BMI:

Body mass index

CI:

Confidence interval

FJS-12:

Forgotten joint score-12

IQR:

Interquantile range

IRB:

Institutional review board

OA:

Osteoarthritis

OR:

Odds ratio

RA:

Robotic arm-assisted

SD:

Standard deviation

TKA:

Total knee arthroplasty

UKA:

Unicompartmental knee arthroplasty

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, Modena, Italy

    Francesco Zambianchi, Valerio Daffara, Andrea Marcovigi & Fabio Catani

  2. Department of Knee Surgery, Policlinico di Abano Terme, Abano Terme, PD, Italy

    Giorgio Franceschi

  3. Statistics Unit, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio-Emilia, Modena, Italy

    Federico Banchelli

Authors
  1. Francesco Zambianchi
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  2. Valerio Daffara
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  3. Giorgio Franceschi
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  4. Federico Banchelli
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  5. Andrea Marcovigi
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  6. Fabio Catani
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Contributions

F. Zambianchi: Interpreted the data and wrote the manuscript. V. Daffara: Drafted the manuscript. G. Franceschi: Collected the data. F. Banchelli: Analysed the data. A. Marcovigi: Revised the manuscript critically. F. Catani: Generated the hypothesis, drafted the manuscript and revised the manuscript critically.

Corresponding author

Correspondence to Francesco Zambianchi.

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Conflict of interest

The authors Francesco Zambianchi, Valerio Daffara, Giorgio Franceschi, Federico Banchelli and Andrea Marcovigi, or any member of their immediate family, have no funding or commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The author Fabio Catani reports consultancy fees, royalties, and fees for participation in review activities from Stryker and consultancy fees from Adler.

Ethical approval

The present study was performed in accordance with the Ethical Standards of the 1964 Helsinki Declaration and its later amendments and IRB approval was obtained (69/2018/OSS/AOUMO, transmitted with protocol N. 0008124/18).

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Zambianchi, F., Daffara, V., Franceschi, G. et al. Robotic arm-assisted unicompartmental knee arthroplasty: high survivorship and good patient-related outcomes at a minimum five years of follow-up. Knee Surg Sports Traumatol Arthrosc 29, 3316–3322 (2021). https://doi.org/10.1007/s00167-020-06198-9

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  • DOI: https://doi.org/10.1007/s00167-020-06198-9

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